Authorize.net Merchant Onboarding Form

This form collects all necessary details to configure your Authorize.net payment gateway and merchant account. Please fill in accurately to avoid delays in processing.

1. Business Information

• Legal Business Name: ____________________________

• DBA (Doing Business As): ____________________________

• Business Address: ____________________________

• Business Phone Number: ____________________________

• Business Email Address: ____________________________

• Website URL: ____________________________

• Customer Support Email: ____________________________

• Customer Support Phone: ____________________________

2. Business Classification

• Business Type:
  ☐ Sole Proprietor
  ☐ Corporation
  ☐ LLC
  ☐ Partnership
  ☐ Non-profit
  ☐ Other: ___________

• Industry Category:
  ☐ Retail (In-Person)
  ☐ eCommerce
  ☐ SaaS / Subscription
  ☐ Professional Services
  ☐ Other: ___________

• Merchant Category Code (if known): ____________________________

• Federal Tax ID / EIN: ____________________________

• Business Start Date: ____________________________

3. Primary Owner / Representative Information

• Full Legal Name: ____________________________

• Date of Birth: ____________________________

• Social Security Number (SSN): ____________________________

• Home Address: ____________________________

• Phone Number: ____________________________

• Email Address: ____________________________

• Ownership %: ____________________________

4. Bank Account for Deposits

• Bank Name: ____________________________

• Account Holder Name: ____________________________

• Routing Number: ____________________________

• Account Number: ____________________________

• Account Type:
  ☐ Checking
  ☐ Savings

• Upload a Voided Check or Bank Letter:
  (Required for ACH funding setup)

5. Transaction Details

• Estimated Monthly Volume (USD): ____________________________

• Average Transaction Amount (USD): ____________________________

• Largest Single Transaction (USD): ____________________________

• How long after a sale do you deliver the product/service?
  ☐ Immediately
  ☐ Within 1–3 days
  ☐ Within 1 week
  ☐ Longer: ___________

• Do you offer refunds or charge recurring payments?
  ☐ Yes
  ☐ No

6. Business Policies

• Return/Refund Policy URL or Text: ____________________________

• Terms and Conditions URL: ____________________________

• Privacy Policy URL: ____________________________

7. Integration & Usage Preferences

How will you use Authorize.net? (check all that apply)
☐ Website checkout (eCommerce)
☐ Recurring subscriptions
☐ Mobile App
☐ Manual entry / Virtual Terminal
☐ Point of Sale (POS)
☐ Invoicing via Authorize.net
☐ Other: ____________________________

• Integration Type:
  ☐ API Integration
  ☐ Hosted Payment Form
  ☐ Shopping Cart Plugin (e.g., WooCommerce, Magento)

8. High-Risk Disclosure (if applicable)

• Do you sell any high-risk or regulated products?
  ☐ Supplements
  ☐ Adult Content
  ☐ CBD or Hemp
  ☐ Firearms or Ammo
  ☐ Cryptocurrencies
  ☐ Other (describe): ____________________________

• Please provide any necessary licenses or documentation.

9. Upload Required Documents

☐ Government-issued ID
☐ EIN Confirmation (IRS SS-4)
☐ Business Registration Document
☐ Voided Check / Bank Letter

10. Additional Notes or Special Instructions